Objective:To analyze the predictive value of serum transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor (VEGF) in patients with non-small cell lung cancer (NSCLC) after single-port thoracoscopic radical resection.Methods:A total of 50 patients with NSCLC who underwent single-port thoracoscopic radical resection in Affiliated Hospital of Xuzhou Medical University from May 2018 to May 2020 were selected as the observation objects. Serum TGF-β1, VEGF levels and Karnofsky functional status (KPS) scores before and after surgery were compared, and the total incidence of complications was calculated. All subjects were followed up for 3 years, and serum levels of TGF-β1, VEGF and KPS scores were compared between relapsed group and non-relapsed group, survival group and death group. Pearson correlation analysis was used to explore the correlation between TGF-β1, VEGF and KPS scores. The receiver operator characteristic (ROC) curve was plotted and the area under the curve (AUC) was calculated to evaluate the predictive value of serum TGF-β1 and VEGF alone and combined detection in patients with NSCLC after single-port thoracoscopic radical resection.Results:The serum levels of TGF-β1 and VEGF were (7.16±1.94) μg/L and (42.26±5.04) ng/L in 50 patients with NSCLC one month after single-port thoracoscopic radical resection, which were lower than those before surgery [ (13.62±3.52) μg/L and (136.52±20.66) ng/L, t=11.37, P<0.001; t=31.34, P<0.001]. The KPS score one month after surgery was 66.57±8.11, which was higher than that before surgery (53.62±5.62, t=9.28, P<0.001). Postoperative wound healing was delayed in 1 of the 50 patients, pulmonary infection in 1 patient, and no pulmonary embolism and other complications occurred. The total incidence of complications was 4.00%. The serum levels of TGF-β1 and VEGF in patients in the relapsed group ( n=6) were (12.95±4.26) μg/L and (72.46±6.05) ng/L respectively, which were higher than those in the non-relapsed group ( n=44) [ (6.37±1.25) μg/L and (38.14±5.37) ng/L; t=8.34, P<0.001; t=29.99, P<0.001]. The KPS score in the relapsed group was 52.16±8.16, which was lower than that in the non-relapsed group (67.55±12.67, t=2.88, P=0.006). Serum levels of TGF-β1 and VEGF in the death group ( n=5) were (13.99±6.82) μg/L and (75.95±9.05) ng/L, which were higher than those in the survival group ( n=45) [ (6.41±3.06) μg/L and (38.52±8.37) ng/L; t=4.56, P<0.001; t=21.47, P<0.001]. The KPS score in the death group was 1.25±0.34, which was lower than that in the survival group (65.11±12.94, t=10.93, P<0.001). Pearson correlation analysis showed that serum levels of TGF-β1 ( r=-0.45, P<0.001) and VEGF ( r=-0.48, P<0.001) were negatively correlated with KPS scores. ROC curve analysis showed that when the optimal cut-off value of TGF-β1 was 8.14 μg/L, the AUC for predicting recurrence after single-port thoracoscopic radical resection was 0.516 (95% CI: 0.446-0.676), the sensitivity was 71.85%, and the specificity was 80.69%. When the optimal cut-off value of VEGF was 142 ng/L, the AUC was 0.659 (95% CI: 0.534-0.761), the sensitivity was 76.04%, and the specificity was 82.52%. The AUC of the combined detection was 0.828 (95% CI: 0.786-0.951), the sensitivity was 91.86%, and the specificity was 87.52%. The AUC of combined detection was higher than that of serum TGF-β1 ( Z=2.63, P=0.007), VEGF ( Z=2.32, P=0.013) single detection. Conclusion:The serum levels of TGF-β1 and VEGF are significantly decreased in NSCLC patients after one month of single-port thoracoscopic radical resection, and the combined detection of the two has predictive value for recurrence after single-port thoracoscopic radical resection.

Objective:To investigate whether prophylactic use of metal clips is necessary after cold snare polypectomy (CSP) of colorectal polyps of 6-10 mm.Methods:A total of 200 patients with 6-10 mm polyps that met the criteria of cold snare resection in Chengdu Third People's Hospital from 15 February 2022 to 30 May 2022 were randomly divided into two groups: a group that received preventive metal clip treatment and an observation group. Age, gender, body mass index (BMI), Boston score, endoscopy entry time, wound size, operation time, intraoperative bleeding time, postoperative delayed bleeding rate and cost between the two groups were compared and analyzed.Results:Ninety-eight patients in the metal clip group had 122 polyps removed, and 97 patients in the observation group had 119 polyps removed. There was no significant difference in the age, gender, BMI, Boston score, endoscopy entry time or wound size between the two groups. There were significant differences in the operation time (171.03±90.78 s VS 69.81±43.26 s, t=2.266， P=0.010), intraoperative bleeding time (19.98±17.37 s VS 29.16±17.56 s, t=-2.875， P=0.006) and surgery cost (571.63±110.92 yuan VS 366.32±13.2 yuan, t=18.102， P<0.001) between the metal clip group and the observation group. There was no significant difference in the delayed bleeding incidence［0.0%（0/98）VS 1.0%（1/97）， P=0.497］between the two groups. Conclusion:For patients with continuous bleeding time <60 seconds after CSP of 6-10 mm colonic polyps, the prophylactic use of metal clips may reduce the bleeding time, but may increase the operation time and cost. Metal clips have little effect on preventing postoperative complications.

Objective To investigate the effect of circ_0114427 on apoptosis and inflammation of alveolar epithelial cells induced by lipopolysaccharide (LPS) and its mechanism. Methods Human alveolar epithelial cells were cultured in vitro and transfected with si-circ_0114427, microRNA (miR)-330-5p mimics or co-transfected with si-circ_0114427 and anti-miR-330-5p, and the cellswere then treated with 10 mg/L LPS for 24 hours. The expression levels of circ_0114427 and miR-330-5p in the cells were detected using real-time fluorescent quantitative polymerase chain reaction (qRT-PCR). The protein levels of Cleaved-caspase3 and Cleaved-caspase9 were evaluated using western blot. Enzyme-linked immunosorbent assay (ELISA) was used to assess the expression of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). Cell apoptosis was analyzed using flow cytometry. The interaction between circ_0114427 and miR-330-5p was validated using a dual luciferase reporter assay. Results After LPS treatment of alveolar epithelial cells, the expression of circ_0114427 was upregulated, while miR-330-5p expression was downregulated in in the cells (P < 0.05). Knockdown of circ_0114427 or upregulation of miR-330-5p could inhibit LPS-induced apoptosis, Cleaved-caspase3, Cleaved-caspase9, IL-6, and TNF-α levels in alveolar epithelial cells (P < 0.05). Circ_0114427 directly interacted with and negatively regulated miR-330-5p. Downregulation of miR-330-5p reversed the inhibitory effect of circ_0114427 knockdown on LPS-induced cell apoptosis and inflammation. Conclusion Knockdown of circ_0114427 can inhibit LPS-induced apoptosis and inflammation in alveolar epithelial cells, possibly through upregulation of miR-330-5p.

Objective The ileum of porcine intestines with radiofrequency (RF) energy was fused through a novel linkage-type pressure controlled electrode, so as to verify feasibility and security of intestinal reconstruction in the RF energy tissue fusion technology. Methods Fresh porcine intestines were fixed on negative electrode in the order of ‘mucosa-serosa’, and then different compressive pressures （497，796，995，1 194，1 492 kPa）and RF energy were applied to the tissues through positive electrode of pressure cone to complete intestinal anastomosis. Biomechanical properties of the fused area were studied by tensile strength and bursting pressure test, and the thermal diffusion and tissue microstructure also studied. ResultsThe anastomotic tensile strength and bursting pressure could reach （8.73±1.11） N and （8.29±0.41） kPa, respectively, when the energy output power, pressure and welding time were 160 W, 995 kPa and 13 s, respectively, and an intact microstructure with little free collagen in the fused area could be observed. Conclusions The technology of RF energy-based tissue fusion could accomplish fast and stable intestinal tract reconstruction, showing great potential in clinical application. It is of great significance to shorten the operation time, simplify the operation process and improve the operation quality.

Objective To develop a new type of electric stapler, so as to solve the problems of insufficient rotation angle, inconvenient operation and difficulty in controlling the pressing strength of existing products. Methods An electric stapler was designed and manufactured. The motion trajectory curve of the prototype was measured by using the three-coordinate imaging instrument to build functional test platform of the prototype, and the goodness of fit was used to evaluate consistency between the theoretical curve and the measured curve. The small intestine tissues of fresh pig were anastomosed at different bending angles of the front end, and the forming rate of the anastomotic stoma was measured. Results The goodness of fit between the test curve and the theoretical curve for both turning motion and shooting motion was ideal, while the goodness of fit between the test curve and the theoretical curve for pressing motion was not ideal when the turning joint was bent at 0°-30°, and was ideal when it was bent at 45°-60°. In performance test, the deformity rate of the nail was smaller than 1.14%, indicating that the bending angle had no significant impacts on the anastomotic effect. Conclusions The kinematics curves of shooting motion and turning motion are consistent with the theoretical curves. The pressing motion curves fluctuate at different bending angles, which will not affect the anastomotic effect, and the effect of the electric stapler meets the clinical requirements.

Objective To compare the safety and clinical efficacy of transcatheter closure for ruptured aortic sinus aneurysm (RASA) with those of surgical treatment.Methods A total of 31 successive patients with RASA,who were treated in a single center during the period from October 2003 to May 2017,were enrolled in this study.Among them,11 patients received transcatheter closure therapy,their mean age was (36.64±10.87) years old;20 patients received surgical closure,their mean age was (28.90± 10.06) years old.The technical success rate,complications,residual shunt,operation time,hospitalization days,amount of blood transfusion,medical expenses,etc.were compared between the two groups.Results No statistically significant differences in age,sex and preoperative cardiac functional grading established by the Heart Disease Association of New York (NYHA) existed between the two groups (P＞0.05).The technical success rates in transcatheter closure group and surgical closure group were 100％ (11/11) and 95％ (19/20)respectively (P＞0.05).The amounts of blood transfusion in transcatheter closure group and surgical closure group were 0 ml and (427.25±331.36) ml respectively (P＜0.01).The time spent for operation in transcatheter closure group and surgical closure group was (60.00±00.00) min and (205.50±129.35) min respectively (P＜0.05).Days staying in intensive care unit (ICU) in transcatheter closure group and surgical closure group were 0 day and (1.50±0.61) days respectively (P＜0.01).The residual shunt rates in transcatheter closure group and surgical closure group were 9.09％ (1/11) and 10.00％ (2/20) respectively.None perioperative death occurred in both groups.No statistically significant differences in hospitalization days and in medical expenses existed between the two groups (P＞0.05).Conclusion Both transcatheter closure and surgical closure are safe and effective for the treatment of ruptured RASA,although transcatheter closure therapy has more advantageous in aspect of minimally-invasive management,operative time and length of hospital stay.For patients with a RASA which position is suitable for percutaneous interventional management,transcatheter closure therapy should be employed as a preferred therapy.

The aim of the present study is to evaluate the vasodilation effects of Tongmai Yangxin Pills (TMYX) on rat mesenteric artery as well as its mechanism of action. The relaxation effects of TMYX extracts with different concentrations were determined on isolated rat mesenteric artery in normal condition as well as pretreating by phenylephrine and KCl. Vascular relaxation effects of TMTX were also determined in mesenteric artery preincubated with L-ANME and indomethacin or in endothelium denuded mesenteric artery. Moreover, effects of TMYX by 50 mg·L⁻¹ on NO secretion and the phosphorylation of eNOS in a cellular model of human umbilical vein endothelial cell (HUVEC) pretreated with or without L-NAME were also observed. The experimental results showed that TMYX has no obvious effect on vasodilation of arteries in normal or KCl pretreated condition, while it can dose-dependently relax the rat mesenteric artery with intact endothelium stimulated with phenylephrine at a maximal diastolic rate of (64.71±10.03)%. After preincubating with L-NAME for 15 min or removal of mesenteric artery endothelium, the maximal diastolic rate was decreased to (35.77±8.93)% and (25.85±10.84)% respectively. However, preincubating with indomethacin had no inhibitory effect on TMYX induced vascular relaxation. Meanwhile, TMYX at 50 mg·L⁻¹ could increase the expression of P-eNOS and the secretion of NO in HUVEC. L-NAME significantly inhibited NO release and phosphorylation of eNOS induced by TMYX. The results suggested TMYX exerted endothelium-dependent relaxation effects against PE-induced contractions of isolated rat mesenteric artery through NO-cGMP signaling pathway.
Animals ; Endothelium, Vascular ; Humans ; Mesenteric Arteries ; Rats ; Vasodilation

Objective To investigate the protective effects and possible mechanism of pigment epithelium derived faetor (PEDF) on myocardial cells H9C2 under hypoxia and serum-free condition.Methods H9C2 cells were culture in vitro and performed the hypoxia and serum-free processing.The cells were divided into the control group (H9C2),hypoxia group (hypoxia + H9C2),PEDF group(hypoxia+H9C2 +PEDF) and mitochondrial fission inhibitor(Mdivi-1) group(hypoxia+h9C2+Mivi-1).The apoptotic rate was detected by TUNNEL staining.The proteins levels of dynamin related peptide1 (Drp1) and cleaved-caspase 3 were measured by Western blot.Electron Microscopy and MitoTracker Red were used to detect the mitochondria morphology,the mitochondrial membrane potential was evaluated by cationic dye JC-1.MitoSOXTM was used to detect mitochondrial reactive oxygen species (ROS).Results Hypoxia induced mitochondrial fission(P＜0.05).The hypoxia group (6 h) and control group had statistical difference(P＜0.05).PEDF reduces mitochondrial fission under hypoxia condition(P＜0.05),which had statistical difference between the PEDF group and hypoxia group (6 h)(P＜0.05).PEDF and Mdivi-1 could decrease cell apoptosis under hypoxia condition(24 h),compared with the hypoxia group,the difference was statistically significant(P＜0.05).Conclusion PEDF decrease cell apoptosis by inhibiting H9C2 cells mitochondrial fission under hypoxia condition.

To implement the excellent doctor education training plan and construct the training model of practical ability in clinical education,the researchers analyzed the problems existing in the training of clinical practice ability and put forward a new train of thought,and constructed a training method system of personal experience,reading classics,teacher guidance,simulation training,clinical practice and reflection strengthening.In addition,we also established a safeguard mechanism with the characteristics of the organizational corporation of teaching,the expert-oriented teaching team,team-oriented mentoring,pro-ject-oriented ability training,the diversification of evaluation system,the modernization of teaching platform and the realistic training environment,to train the qualified clinical medical talents.

Animals ; Copper ; toxicity ; Disulfiram ; toxicity ; Humans ; Leukemia, Myeloid, Acute ; Mice ; Mice, Inbred NOD ; Mice, SCID